Patient Stories 
Jim Phillips has probably spent as much of his waking life outdoors as indoors. He coached baseball, track and swimming in the Lead-Deadwood area. Now retired, he loves biking, kayaking and tending to his five-acre homesite in Boulder Canyon. Plus, Jim is an avid swimmer. In the summer of 2018, he and a friend swam across all 23 lakes in the Black Hills – 26.6 miles total.
“All my life, I’ve kind of been a sun worshiper. Back in my era, sunscreen wasn’t a big deal,” he said. “I’m 78, so that’s how many years I’ve abused the heck out of my skin.”
In fact, it was swimming that made him aware that a spot on his nose, right where his swim goggles sit, would not heal. “I’d get done with a race or something, and I’d be bleeding from my nose,” he said.
Over the years, Jim has undergone various treatments to remove precancerous and cancerous growths. But this time it seemed more serious, Jim said. And it was. At Monument Health Dermatology in Spearfish, he found out the spot was basal cell carcinoma.
Basal Cell Carcinoma
It’s a type of cancer that begins in the basal cells, the part of the epidermis that constantly makes new skin cells and pushes them to the surface. A DNA mutation causes the cells to multiply rapidly and continue growing instead of dying off to make room for new healthy cells. Chronic sun exposure, radiation therapy, fair skin and increasing age are among the primary risk factors.
The good news is that Mohs surgery is an extremely effective treatment for skin cancer. It’s known for a high cure rate and tissue-sparing results. Dermatologist Christopher Gasbarre, D.O., at Monument Health Dermatology in Spearfish, is a board-certified dermatologist and Fellow of the American College of Mohs Surgery. This year, he was joined in the Spearfish clinic by Mary Logue, M.D., a dermatologist who is also board-certified in the procedure.
Dr. Gasbarre is a board certified dermatologist and Fellow of the American College of Mohs Surgery who practices in Spearfish. He enjoys treating any and all conditions of the skin, but is particularly interested in the treatment of skin cancer. He has published and edited numerous articles and book chapters, as well as lectured internationally. He is a proud and devoted husband and father.
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Listen to Dr. Gasbarre’s Podcast episodes now, www.monument.health/podcast.
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Mohs Surgery
Mohs surgery is an outpatient procedure. The tumor and a small amount of surrounding tissue are surgically removed. While the patient waits, the cells are sliced, mapped and examined under a microscope. If the layer has cancer cells, another layer is removed, then examined in the same way. When all the cells in a layer are clear of cancer, Dr. Gasbarre closes the wound and sends the patient home to heal.
“Because Mohs surgery removes the least amount of healthy tissue, patients are left with smaller, more manageable wounds,” Dr. Gasbarre said. “For this reason, Mohs procedures work especially well on areas of the body in which sparing tissue is important, such as near the eyes, ears or nose.”
In Jim’s case, the tumor site on his nose is practically invisible today. He had the surgery on Jan. 3 at the Monument Health Dermatology clinic in Spearfish. It took about three hours.
“Three hours was nothing. I had a basketball game on TV, and I took a nap,” he said. During the surgery parts of the procedure, he chatted comfortably with Dr. Gasbarre, Certified Nurse Practitioner Darbi Anderson and other staff members about everything from liver and onions to the difference between aerobic and anaerobic exercise.
These days, Jim is a big believer in taking care of his skin. He still spends a lot of time outdoors, but he’s using lots of sunscreen. When he’s out doing yard work, he wears his favorite Chicago Bears baseball cap.
“And my wife got me some cream that makes my skin look like it’s only 75 years old now,” he added with a chuckle.